Title

Author

Year of Publication

2016

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Linda Alexander, EdD

Committee Member

Robin Vanderpool, DrPH, CHES

Committee Member

Ramona Stone, PhD, MPH

Abstract

The Coalition of Kentucky Health Professionals Against Substance Abuse (CKHPASA) is a professional organization uniting members of the various health professions against a rising tide of substance abuse in the state of Kentucky. In 2013, Kentucky ranked 3rd in the United States for highest number of drug overdose fatalities. Previously under the scourge of the prescription opioid epidemic, the state of Kentucky is now seeing rising numbers of overdose deaths related to heroin use, which is an opioid that works similarly to morphine and prescription pain medications.

Naloxone is a life-saving antidote for opioid related overdoses and evidence has shown dramatic decreases in overdose related deaths as access to at-home naloxone increases. Senate Bill 192, signed into law in 2015, grants Kentucky pharmacists the ability to dispense naloxone to patients requesting it at their pharmacy without an expressly written physician’s prescription. The pharmacists must be certified to dispense naloxone by the Kentucky Board of Pharmacy and enter into a collaborative care agreement with a local physician to be capable of dispensing naloxone in this manner.

In eastern Kentucky in rural Appalachia, access to physicians, emergency services, and hospitals is diminished compared to suburban and urban areas of the state. In these disparate communities, at-home naloxone obtained at the local pharmacy will reduce overdose related mortality and morbidity by increasing access to the antidote and overcoming barriers to timely emergency response. In the context of this grant, CKHPASA will utilize board-certified pharmacists in collaborative care agreements with local physicians to provide addicts and their loved ones in Bell, Breathitt, Floyd, Harlan, and Perry counties with access to naloxone as a harm reduction strategy.

These five counties were among the highest ranked in overdose death rate per capita in the state of Kentucky in 2013 and are the focus of this intervention. This intervention is modeled after two successful Overdose Education and Naloxone Distribution (OEND) programs. It will provide naloxone via auto-injector to addicts or their loved ones, the necessary education to successfully administer the naloxone in the event of an overdose situation, and information on resources in the area to assist the opioid addict on their journey toward lasting sobriety along the Transtheoretical Model of Change.